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Tohid Pirbodaghi
Nowadays, sacrificing animals to develop medical devices and receive regulatory approval has become more common, which increases ethical concerns. Although in vivo tests are necessary for development and evaluation of new devices, nonetheless, with appropriate in vitro setups and mathematical models, a part of the validation process can be performed using these models to reduce the number of sacrificed animals. The main aim of this study is to present a mathematical model simulating the hydrodynamic function of a rotary blood pump (RBP) in a pulsatile in vitro flow environment...
January 18, 2017: Artificial Organs
A Dave Nagpal, Rohit K Singal, Rakesh C Arora, Yoan Lamarche
With more than 60 years of continuous development and improvement, a variety of temporary mechanical circulatory support (MCS) devices and implantation strategies exist, each with unique advantages and disadvantages. A thorough understanding of each available device is essential for optimizing patient outcomes in a fiscally responsible manner. In this state of the art review we examine the entire range of commonly available peripheral and centrally cannulated temporary MCS devices, including intra-aortic balloon pumps, the Impella (Abiomed, Danvers, MA) family of microaxial pumps, the TandemHeart (CardiacAssist Inc, Pittsburg, PA) pump and percutaneous cannulas, centrally cannulated centrifugal pumps such as the CentriMag (Thoratec Corp, Pleasanton, CA/St Jude Medical, St Paul, MN/Abbott Laboratories, Abbott Park, IL) and Rotaflow (Maquet Holding BV & Co KG, Rastatt Germany), and extracorporeal membrane oxygenation...
January 2017: Canadian Journal of Cardiology
Toshinobu Kazui, Phat L Tran, Angela Echeverria, Catherine F Jerman, Jessika Iwanski, Samuel S Kim, Richard G Smith, Zain I Khalpey
BACKGROUND: Right ventricular failure is a serious complication after left ventricular assist device placement. CASE PRESENTATION: A 70-year-old male in decompensated heart failure with right ventricular failure after the placement of a left ventricular assist device. A single dual-lumen PROTEKDuo cannula was inserted percutaneously via the internal jugular vein to draw blood from the right atrium and return into the pulmonary artery using the CentriMag system, by passing the failing ventricle...
August 4, 2016: Journal of Cardiothoracic Surgery
Michael F Swartz, Ron Angona, Karen Smith, Franca Kraenzlin, Christine M Stypula, Devang Joshi, Vakhtang Tchantchaleishvili, George L Hicks, H Todd Massey
Bi-ventricular (Bi-V) mechanical circulatory support is commonly used as a bridge to cardiac transplant. However, the optimal strategy is unknown. We examined the outcomes, as well as the costs in the use of Bi-V support as a bridge to cardiac transplant. From 2001 to 2014, three different Bi-V support strategies were utilized: 1) Para-corporeal ventricular assist device (PVAD-2001-2006), 2) Heartmate II left ventricular assist device in conjunction with a temporary CentriMag right ventricular assist device (HMII + CMAG-2006-2012), and the total artificial heart (TAH-2012-2014)...
September 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Laura McGarrigle, Jennifer Caunt
BACKGROUND AND PURPOSE: Short-term ventricular assist device (VAD) support is used in the intensive care unit (ICU) to support individuals in end-stage heart failure prior to heart transplantation or implantation of a long-term left VAD. The literature investigating the feasibility, safety, and content of rehabilitation for this patient group is lacking. This report retrospectively describes the rehabilitation strategy, safety measures used, and nature of any adverse events and, therefore, the feasibility of this practice...
December 2016: Physical Therapy
Ta-Chung Shen, Kuei-Ton Tsai, Chin-Yuan Hu, Robert Jeen-Chen Chen
The CentriMag, an extracorporeal short-term ventricular assist device designed for treatment of patients with acute cardiogenic shock, is Conformité Européenne-marked in Europe for use up to 30 days. Extended use beyond the licensed period is not uncommon, however. We have developed a skirted cannula technique for apical cannulation in implantation of the Centrimag. This technique allows easy positioning of the cannula and excellent hemostasis. It also offers secure fixation of the cannula so that patients can ambulate and attend rehabilitation programs should extended use be anticipated...
June 2016: Annals of Thoracic Surgery
Mohamed Zeriouh, Prashant Mohite, Binu Rai, Anton Sabashnikov, Javid Fatullayev, Diana Garcia Saez, Bartrlomiej Zych, Ali Ghodsizad, Parwis Rahmanian, Yeong-Hoon Choi, Thorsten Wahlers, Andre R Simon, Aron F Popov, Achim Koch
PURPOSE: Low cardiac output syndrome is associated with significant mortality. In patients with refractory low cardiac output left ventricular assist devices (VAD) are used to re-establish cardiac output and to prevent death. However, long-term LVAD implantation in these is complicated by a high rate of right heart failure and mortality. Therefore, our strategy is to implant a short-term VAD (left or biventricular) as a bridge to decission. METHODS: We retrospectively analysed data from 66 patients who received a short-term LVAD support prior to implantation of a long-term LVAD or HTx between 2003 and 2014...
May 16, 2016: International Journal of Artificial Organs
Jennifer Conway, Mohammed Al-Aklabi, Don Granoski, Sunjidatul Islam, Lyndsey Ryerson, Vijay Anand, Gonzalo Guerra, Andrew S Mackie, Ivan Rebeyka, Holger Buchholz
BACKGROUND: Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being used in the pediatric population. However, little is known about the outcomes in patients supported with these devices. METHODS: All pediatric patients supported with a STCF-VAD, including the Thoratec PediMag or CentriMag, or the Maquet RotaFlow, between January 2005 and May 2014, were included in this retrospective single-center study. RESULTS: Twenty-seven patients (15 girls [56%]) underwent 33 STCF-VAD runs in 28 separate hospital admissions...
May 2016: Journal of Heart and Lung Transplantation
Awais Ashfaq, Alyssa B Chapital, Daniel J Johnson, Linda L Staley, Francisco A Arabia, Kristi L Harold
Objectives Increasing number of mechanical circulatory assist devices (MCADs) are being placed in heart failure patients. Morbidity from device placement is high and the outcome of patients who require noncardiac surgery after, is unclear. As laparoscopic interventions are associated with decreased morbidity, we examined the impact of such procedures in these patients. Methods A retrospective review was conducted on 302 patients who underwent MCAD placement from 2005 to 2012. All laparoscopic abdominal surgeries were included and impact on postoperative morbidity and mortality studied...
October 2016: Surgical Innovation
Areo Saffarzadeh, Pramod Bonde
Temporary mechanical circulatory support (MCS) refers to a group of devices generally used for less than 30 days to maintain adequate organ perfusion by compensating for a failure of the pumping mechanism of the heart. The increased availability and rapid adoption of new temporary MCS strategies necessitate physicians to become familiar with devices placed both percutaneously and via median sternotomy. This review will examine the different options for commonly used temporary MCS devices including intra-aortic balloon pumps (IABPs), veno-arterial-extracorporeal membrane oxygenation (VA-ECMO), TandemHeart(®) (CardiacAssist, Pittsburg, PA, USA) Impella(®) and BVS 5000(®) (both Abiomed Inc...
December 2015: Journal of Thoracic Disease
James R Neal, Eduard Quintana, Roxann B Pike, James D Hoyer, Lyle D Joyce, Gregory Schears
Patients supported with extracorporeal membrane oxygenation (ECMO) or short-term centrifugal ventricular assist devices (VADs) are at risk for potential elevation of plasma-free hemoglobin (pfHb) during treatment. The use of pfHb testing allows detection of subclinical events with avoidance of propagating injury. Among 146 patients undergoing ECMO and VAD from 2009 to 2014, five patients experienced rapid increases in pfHb levels over 100 mg/dL. These patients were supported with CardioHelp, Centrimag, or Pedimag centrifugal pumps...
June 2015: Journal of Extra-corporeal Technology
Cory M Alwardt, Donald S Wilson, Michelle L Alore, Louis A Lanza, Patrick A Devaleria, Octavio E Pajaro
Extracorporeal membrane oxygenation (ECMO) is indicated when conventional measures fail to support a patient during cardiac or respiratory failure. Due to the complicated nature of ECMO, patients often require transport to a tertiary care center. This study retrospectively compared the performance of the Cardiohelp™ (Maquet) life support system with a previously used ECMO circuit when transporting adult patients on venoarterial ECMO between facilities. Two ECMO circuits were compared for performance: 1) the Cardiohelp™ (Maquet) life support system and 2) the "standard" circuit consisting of a Thoratec CentriMag centrifugal pump, Maquet Quadrox-D oxygenator, and a Terumo CDI-500 in-line blood gas analyzer...
March 2015: Journal of Extra-corporeal Technology
Mark J Russo, Claudia Gidea, Ravi Karanam, David A Baran, Craig R Saunders, Mark J Zucker, Margarita T Camacho
Continuous-flow ventricular assist devices (CVADs) are associated with a significant complication profile that includes thrombosis of the ascending aorta and aortic valve, thromboembolism, and stroke. Despite an increasing number of reports of thromboembolic complications related to CVADs, there is little in the literature to guide their management. This report describes successful management strategies used during two cases of thrombosis of the ascending aorta during biventricular CentriMag (Levitronix LLC, Waltham, MA) support, including using pre-existing cannulas to initiate cardiopulmonary bypass...
December 2014: Journal of Extra-corporeal Technology
Rymbay Kaliyev, Timur Kapyshev, Alex Goncharov, Timur Lesbekov, Yuri Pya
Use of extracorporeal membrane oxygenation (ECMO) for severe cardiopulmonary failure has increased because of improved outcomes. A specially designed ECMO transport system allows for safe transport of patients over long distances. We report a 28-year-old pregnant woman (26 weeks gestation) with acute respiratory distress syndrome in whom ECMO support was necessary for survival, and she was transported to another facility 1,155 km away with the aid of the portable ECMO system. Transport was uneventful, and the patient's condition remained stable...
September 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Adam Sieg, B Andrew Mardis, Caitlin R Mardis, Michelle R Huber, James P New, Holly B Meadows, Jennifer L Cook, J Matthew Toole, Walter E Uber
Because of the complexities associated with anticoagulation in temporary percutaneous ventricular assist device (pVAD) recipients, a lack of standardization exists in their management. This retrospective analysis evaluates current anticoagulation practices at a single center with the aim of identifying an optimal anticoagulation strategy and protocol. Patients were divided into two cohorts based on pVAD implanted (CentriMag (Thoratec; Pleasanton, CA) / TandemHeart (CardiacAssist; Pittsburgh, PA) or Impella (Abiomed, Danvers, MA)), with each group individually analyzed for bleeding and thrombotic complications...
September 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
David Schibilsky, Matthias Lenglinger, Meltem Avci-Adali, Christoph Haller, Tobias Walker, Hans Peter Wendel, Christian Schlensak
The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component...
August 2015: Artificial Organs
Curt Tribble, Miguel Urencio, Giorgio Aru, Walter Merrill
BACKGROUND: The therapeutic options for heart failure include inotropic agents, intraaortic balloon pumps, and left ventricular assist devices (LVAD). Implantable LVADs are not appropriate for all patients. The short-term devices require patients to stay in bed, connected to cannulas, which are usually inserted using a median sternotomy. This approach requires a subsequent sternotomy, midline cannulas (which can make sitting difficult), and immobility. We began using a right thoracotomy with cannulas placed through intercostal spaces for selected patients in need of temporary LVAD support...
June 26, 2015: Heart Surgery Forum
Dongfang Wang, Cameron Jones, Cherry Ballard-Croft, Ju Zhao, Guangfeng Zhao, Stephen Topaz, Joseph B Zwischenberger
The objectives were to design/fabricate a double-lumen cannula (DLC) for a percutaneous right ventricular assist device (pRVAD) and to test the feasibility/performance of this pRVAD system. A 27 Fr DLC prototype was made and tested in six adult sheep. The pRVAD DLC was inserted into the right jugular vein; advanced through the superior vena cava, the right atrium (RA), the right ventricle (RV); ending in the pulmonary artery (PA). A CentriMag pump and optional gas exchanger were connected to the DLC. Blood was withdrawn from RA, pumped through gas exchanger, and perfused PA...
July 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Anton Sabashnikov, Tom Butters, Benjamin Högerle, Mike Hedger, Mohamed Zeriouh, Javid Fatullayev, Alexander Weymann, Yeong-Hoon Choi, Thorsten Wahlers, Aron-Frederik Popov, André R Simon
Multiple implantations of left ventricular assist devices over a period of three years were performed in a 17-year-old gentleman with non-ischaemic dilated cardiomyopathy and congestive cardiac failure. The first device (HeartMate II) was implanted as a bridge to transplantation. However, after few months of support the patient showed signs of myocardial recovery and the device was successfully explanted. After 2 years of uneventful follow-up, the patient's condition deteriorated requiring further mechanical support...
June 2015: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
B Mohamedali, G Bhat, G Yost, A Tatooles
OBJECTIVE: Temporary mechanical assist devices are increasingly being used as a lifesaving bridge to decision in patients requiring cardiopulmonary resuscitation. We report our single-center experience with biventricular Centrimag® pumps over a five-year period. METHOD: Data was retrospectively collected in consecutive patients who required biventricular support from 2008 to 2013. Patients who were supported with central cannulation using the Centrimag® system were analyzed...
April 2015: Perfusion
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